How Four Students Solved a Difficult Mental-Health Service Problem

The winners of this year's National Public Policy Challenge had a guiding principle: Think big, start small.

For Kayla Cheatham, adult mental health is a personal and professional passion. On March 17, Cheatham's efforts to help people with mental-health problems took a powerful, practical step forward.

Cheatham has worked for Jewish nonprofits for five years and interned as both a family-crisis case manager and an inpatient psychiatric case manager. In November of last year, as a candidate for a master's degree in social work from the University of Pennsylvania, she applied to participate in the National Public Policy Challenge, an annual invitational event hosted by the Fels Institute of Government at Penn in collaboration with Governing.

Sponsored by the Knight Foundation and Deloitte Consulting, the Public Policy Challenge is an opportunity for students from a variety of disciplines to address current social issues and to connect both with their peers and with leaders from the public-sector arena. Modeled after MBA business-plan competitions, the competition asks student teams to develop original policy proposals and innovative civic campaign plans to help achieve meaningful change in their communities. Teams of three to five students from nine universities participated in this year's second annual challenge.

When Sarah Besnoff, who manages Penn's internal competition, got Cheatham's application, she matched her with three other Penn students, each of whom, like Cheatham, had written about health-care problems in Philadelphia and had listed health as their highest-priority policy interest: Molly Viscardi, a doctoral candidate in nursing who works as a nurse in the emergency department of Jefferson Hospital; Meghan O'Brien, a medical student who works at Puentes de Salud, a clinic serving Spanish-speaking Philadelphians; and Dan Bernick, who's pursuing a master's in public administration and is president of the undergraduate assembly at Penn.

Thus was born team re:Mind, whose project won the Public Policy Challenge. Their project is a text-message-based appointment-reminder service for patients recently discharged from inpatient psychiatric care to facilitate attendance at their first outpatient follow-up appointments. The program targets the most common reason that patients miss their appointments: They forget. The nine contest judges, seven of them former Governing Public Officials of the Year, were convinced that this cost-effective, research-based intervention to facilitate transitions between care settings has the potential to save Philadelphia millions of dollars in wasted time and preventable hospitalizations.

The winners: Sarah Besnoff, Meghan O'Brien, Molly Viscardi,

Dan Bernick and Kayla Cheatham with Fels Institute Executive

Director David Thornburgh (Photo: Fels Institute)

The project these students put together is a testament not just to brains, passion and creativity. It also is a testament to the power of interdisciplinary thought. Each of these accomplished students brought something different to the table. They were all interested in health care, but it had become clear to them that mental health was an area in which there is a great deal to be done. O'Brien said that while access to all forms of health care is critical because there are so few primary-care providers, this was especially so in mental health. Bernick said that when Cheatham proposed the reminder system for mental-health patients, it was so intuitive that he couldn't imagine that it wasn't already happening. Viscardi said that while the team had lots of ideas but that this one seemed the most doable and that Bernick, who had participated in the Public Policy Challenge before, kept pushing them to make it more doable: He encouraged them to think big and start small. And it was someone not on the team, O'Brien's sister, who came up with the project's name.

The hallmark of a truly good idea, as Bernick suggested, is that when you learn about it you think that it's remarkable that no one ever thought of it before. That was the reaction of the judges, and it also was the reaction of some of the public officials who work in mental health in the Philadelphia area. Community Behavioral Health (CBH), the administrative service organization that provides behavioral-health coverage for Philadelphia's 526,000 Medicaid recipients, announced two days before the Public Policy Challenge presentations that the agency would partner with the re:Mind team to implement their program.

That program will get a boost right away from the re:Mind team's prize money--$5,000 for reaching the finals plus an additional $10,000 for having the winning initiative. "We're hoping to use some of the funds from the winnings to really get re:Mind off the ground and running, and do that in collaboration with CBH so that we can move this forward," says O'Brien. And they already have their first employee: Kayla Chatham.

This column has been updated to correct the spelling of Sarah Besnoff's last name.